Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum
John D Fulk, P.A.
Physician Assistant in Normal, IL · enumerated 2005.
Data current as of Jul 13, 2026 · sourced from CMS NPPES
National Provider Identifier
1063419679
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Registry record
Entity type Individual (Type 1)
Name John D Fulk
Credential P.A.
Sex Male
Practice address 1302 Franklin Ave, Suite 4800, Normal, IL, 61761
Phone (309) 454-5900
Fax (309) 454-2820
Enumeration date Jun 29, 2005
Last updated in NPPES Apr 4, 2019
Taxonomy & licenses
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 085001126 (IL) Primary
PA — Physician Assistant: A licensed clinician who practices medicine in collaboration with physicians, trained in a graduate PA program.
About the PA credential
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty.
Frequently asked questions
Is NPI 1063419679 active?
Yes — as of the latest NPPES snapshot, NPI 1063419679 is active (record last updated 2019-04-04).
How do I verify John Fulk's NPI record?
Cross-check NPI 1063419679 against the official CMS registry at npiregistry.cms.hhs.gov. This page mirrors the same public NPPES data with a monthly snapshot.
Other providers at this practice address
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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2019-04-04.